It is something that comes up time and time again when talking to parents about making choices about their maternity care: It goes something like this...
Mum: I know that I could have done, but I didn't email the Head of Midwifery asking her to grant permission for me to **use the pool for my VBAC because I didn't want to be 'that' person, I didn't want to ruffle any feathers ahead of my birth and then be treated differently because of it.
**insert any reason here
The thing is being 'treated differently' actually is a desirable thing. To be treated differently would mean to you are being treated as an individual. It would mean that the midwife or other medical professional delivering your care would know what it is that you want and need. Yes they have hospital policies and guidelines for stuff that they must *offer* you, but what every medical professional is there to offer (and WANTS to offer) is personalised care, just. for. you.
It is so important to remember that this is just one moment in the possibly (hopefully) multiple-decade long career of the person handling your care, but for you it is quite probably a life changing moment, one that could make or break you for not only your early parenting years, but well into your later years of life too.
I have personally found that those people who do their research and let their care providers know what it is that is most important to them actually receive the most gentle loving care because the people around them know what they want and need, not the other way around.
Siâna Gordon's experience below was the inspiration for this blog-
I saw the same community midwife for my second baby that I did for my first so she already knew that I would have my own plans. When I had my booking appointment with her I asked soooo many questions about the different blood tests and screening tests to find out what I actually wanted to consent to. I apologised because she had to go away and check a couple of things for me and she said "no don't worry, I love supporting people who ask questions, it makes me stop and think about things in a different way. These are your decisions at the end of the day, and whether it's what I think or not, you making informed decisions for yourself is what makes me know I'm doing my job right".
Then I had accepted bump measurements throughout, but at my homebirth assessment I declined as she had a student midwife with her so it would have been a different person taking the measurements and would have been on my sofa. She said "that's fine, you are completely within your rights to decline measurements. I am always interested in hearing your reasoning behind your decision making if you are happy to share? Of course you don't have to have a reason or share it with us though!" And then when I talked through my thinking she said "that's very clever thinking, don't want any reasons to derail a homebirth at this point".
She was just so supportive of all my choices and made me feel like she enjoyed our appointments and chats rather than finding me difficult. I went on the ask a group of midwives for their input and the responses were so warming...
Suz Anne's experience as a midwife-
When someone wants to birth outside of the trust guidance it means that I have accurately conveyed the elements of choice in the interventions offered. It means that they trust me, that they trust themselves, and knowing and trusting your own body and judgment is the most powerful thing.
I always say that the power of a birth plan isn’t necessarily what gets printed onto the paper but the research that underpins those choices and the knowledge it gives you if you want to deviate from it. It means that I know what’s important to you, and I know how to advocate for you if you feel unable to yourself.
Ellie Longbone's experience as a midwife:
Newly qualified midwife here.. I LOVE looking after the women who are 'feather rufflers' and who know exactly what they want. Some of the most amazing births I've supported were the mums who had done the research, written a birth plan and who understand that they have choice. Honestly, I can count on one hand the amount of times I've seen a physical birth plan but it makes me so happy when someone brings one in because I can understand their birth preferences in more detail and in advance.. it can be tricky discussing someone's preferences when they're in the middle of labour and I don't like risking disrupting their oxytocin flow. It also makes it much easier to advocate for their choices when they've planned in advance. In my opinion, it's my job to listen to how they want their birth to be and to try my absolute hardest to help them achieve that. I've found with this kind of attitude, birthing people trust me more so when things occur that might mean a change in plans, we can calmly talk through the options and clinical reasoning so they can make an informed choice.
I've been lucky to have worked with some amazing midwives as a student who share these views but I know that perhaps not all midwives will. At the end of the day though, we need to help birthing people see that this is one of the most important experiences for them and their baby. It's not about the judgements of other people and if anyone does make unfair judgements, that says way more about them than the birthing person.
I could probably rant about this forever
Eleanor Cramer's experience as a midwife-
When a pregnant/birthing person expresses their needs, gives critical feedback or especially when they say no to something, it makes me feel safer as a practitioner. I feel safe that she could tell me if I were overstepping, safe that she will ask if she doesn't understand what I've said. I practice much more anxiously and instrusively with people where I'm not sure if they can assert themselves - I will check in many more times that something is ok with them and that they're happy with their decisions etc.
Being a midwife, you wield a huge great dangerous bit of institutional power. When you're driving that around, you actively want other people to be lit up and road markings etc to show you where you should and shouldn't go. Like, naturally don't be an arsehole about it, don't stick your full beam in my eyes, but please please don't feel guilty for turning your lights on, it is HELPFUL for me to know what you want/need.
(The metaphor breaks down a bit because there are some people who can't turn their lights on and assert their boundaries or sometimes even work out where their boundaries are because they're terrified/traumatised. And it's not their fault if those boundaries are then crossed by professionals, it's always on the professionals to slow down make sure they've checked in as much as possible to figure out where those boundaries might be.)
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